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Management of pregnancy in women with rheumatoid arthritis

Gene-Siew Ngian, Andrew M Briggs, Ilana N Ackerman and Sharon Van Doornum
Med J Aust 2016; 204 (2): 62-63. || doi: 10.5694/mja15.00365
Published online: 1 February 2016

Summary

  • Rheumatoid arthritis (RA) disease activity may improve during pregnancy but postpartum flares are common.
  • Patients taking disease-modifying antirheumatic drugs should be counselled about effective contraception.
  • Knowledge about drug safety in pregnancy is limited but the Therapeutic Goods Administration categories and online resources are a guide to the data currently available.
  • Begin prepregnancy counselling as early as possible to allow for cessation of teratogenic medications and optimisation of RA disease control.
  • For unplanned pregnancies, cease teratogenic medications immediately and refer to a genetic counsellor and maternal–fetal medicine specialist for risk assessment and advice.

  • Gene-Siew Ngian1
  • Andrew M Briggs2
  • Ilana N Ackerman3
  • Sharon Van Doornum1,3

  • 1 Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Melbourne, VIC
  • 2 Arthritis and Osteoporosis Victoria, Research and Knowledge, Melbourne, VIC
  • 3 Melbourne EpiCentre, Melbourne Health and University of Melbourne, Melbourne, VIC

Correspondence: gene-siew.ngian@mh.org.au

Competing interests:

This was an investigator-initiated review, but we received research grants from UCB and AbbVie. Neither company had any input into the design or execution of our review.

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